New Innovations Logging Primer

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Duty Hour Logging in New Innovations: A Primer
Why do we care? ACGME requires that we log hours and justify violations, so we all need to know what all these hours requirements are so we can help each other avoid true violations, and how to log in New Innovations to avoid false violations due to software quirks.

What are those ACGME requirements?
  1. Weekly hours: No more than 80 hours/week averaged over 4 weeks. Callback only counts towards this for hours you actually worked in the hospital.
  2. Shift length: For R2/R3’s: No more than 24 consecutive hours + 4 additional for transitional activities. For R1’s: no more than 16 consecutive hours (no transition time beyond this)
  3. Short Break: must have 10 hours scheduled between shifts. 8h is bare minimum and acceptable if there is a specific justification for patient care / safe hand-off. Rule does NOT apply when called in from callback.
  4. Night Float: no more than 6 consecutive nights
  5. Day Off: at least one 24 hour period without scheduled activity per week averaged over 4 weeks

How to log in New Innovations:
  1. Log your hours each and every week.
  2. Log all hours continuously for the day to avoid false "short break" violations. Do NOT put gaps in your schedule for lunch, for an afternoon off, between anesthesia and ED shift, etc. Just log it as if you were working continuously even if you actually went home and took a nap.
  3. Be mindful of the shifts with exactly 10 hours scheduled off (see below). Help each other get out on time and log time you stay over as “sign-out time”. Must still have minimum of 8h off.
  4. Log any hours past 24h on OB as “sign-out time” (up to 4h)
  5. For callback: log ONLY the hours you were called in as “Callback – called in”. These hours count towards 80h/wk but short break violations are excused. Do NOT log “Callback – not called in”.
  6. Log vacation days as 8h vacation per weekday you are off
  7. For continuity deliveries: log these hours, if you get a violation then document it was for a continuity delivery

Watch out for these shifts that come up against duty hours: please help each other get out on time!
    1. Short Break – must have at least 10h scheduled, if stay over , minimum 8 (log extra hours as “sign out time”)
      • Evening ICU resident must leave by 9pm (back at 7am the next morning)
      • Short Admit must leave hospital by 10pm (outpatient activity at 8am next morning)
      • Inpatient: you should not be working past 8pm the day prior (back at 6am). If you are, stop and ask your attending to help you with any pending work the next day.
      • NHO must leave promptly at 7am on Fridays (back at 5pm)
      • NF (Night ICU) must leave at 8am (back at 6pm).
    2. Shift Length : 24h OB call must leave by 10:30am (24+4) and document hours beyond 24 as “sign out time”
    3. 80h/wk : ICU and inpatient often come close to this, and sometimes residents go over. It is really important that you keep track of your hours on an on-going basis and work with your attending to stay under this limit.

It is residency program's intention to never schedule a resident in such a way that violates any of the ACGME duty hour rules, or impose a workload that results in their violation.
    1. If you are concerned that you are scheduled in a way that may be a violation, please contact the scheduler (schedule@ccfamilymed.com or text/call/page Kendra) right away so she can fix it
    2. There will soon be a system in place for attendings and residents to review hours weekly on inpatient and ICU rotations (where we have the most issues going over hours) so you can work collaboratively together to adjust your workload and workflow to keep you under hours.

Your chiefs, October 2015